Heroes of Newerth pits two teams of players against each other: the Legion and the Hellbourne.[3] Both teams are based at opposite sides of a map. The standard map is split into three continuous 'lanes' (Two in one of the lesser played maps), running from one base to the other. Defensive towers are positioned evenly through each lane, until the lanes terminate at a team's base. Bases are strongly defended with extra defensive towers, and buildings from which units spawn. These units, termed 'creeps' are spawned every thirty seconds, and run along their lane until they meet opposition - which they then attack. Victory is achieved when one of the teams manages to push into the base of the opposing team, and destroys their primary structure; the Hellbourne's 'Sacrificial Shrine', or the Legion's 'Tree of Life'. At any point after fifteen minutes has expired a team can choose to concede defeat - this loses them the game and requires a unanimous team vote to pass or a 'four of five' vote after the thirty minute mark.

Players on each team choose one of 82 different heroes, each with various abilities and advantages to form their overall strategy. The players in Heroes of Newerth control a single hero and their development from a top-down perspective, while common features of real time strategy games such as base management and resource collection are removed.[4] Each hero has 4 different abilities which can be learned and upgraded as the hero gains experience and levels up. Experience is gained for being within range of enemy heroes and creeps when they are killed. The maximum level a hero can achieve is 25 and the experience required per level gain increases with each new level. The only resource that a player controls is gold which is used for buying various items for his or her hero. Every hero has small periodic gold income but most of it is gained for killing creeps, enemy heroes and destroying base structures (like defensive towers). All heroes involved in the death of an enemy hero are rewarded exp and assistance kill gold, while the hero that dealt the killing blow gets the most gold, In turn, enemy heroes can terminate their own creeps when they are almost dead to prevent the enemy from placing the killing blow and gaining additional gold and experience. These techniques are called last hitting and denying, both of which are very important early in the game. When a hero dies, he loses a part of his gold and after a certain amount of time, based on their level, respawns at the well located in their team's respective base.

Once started, average game length is around 40–50 minutes.[5] Players on the winning team gain ranking points while the other team loses them. Ranking points are used to place players on the ladder system and it has no influence on game play- players are always on equal footing despite their ranking.